Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
Int J Qual Health Care. 2012 Jun;24(3):239-49. doi: 10.1093/intqhc/mzs015. Epub 2012 Apr 11.
To identify the prevalence of potentially preventable medication-related hospitalizations amongst elderly Australian veterans by applying clinical indicators to administrative claims data.
Retrospective cohort study in the Australian veteran population from 1 January 2004 to 31 December 2008.
A total of 109 044 veterans with one or more hospitalizations defined by the medication-related clinical indicator set, during the 5-year study period.
The prevalence of potentially preventable medication-related hospitalizations as a proportion of all hospitalizations defined by the clinical indicator set.
During the 5-year study period, there were a total of 1 630 008 hospital admissions of which 216 527 (13.3%) were for conditions defined by the medication-related clinical indicator set for 109 044 veterans. The overall proportion of potentially preventable medication-related hospitalizations was 20.3% (n= 43 963). Of the 109 044 veterans included in the study, 28 044 (25.7%) had at least one potentially preventable medication-related hospitalization and 7245 (6.6%) veterans had two or more potentially preventable admissions. Conditions with both a high prevalence of hospitalization and preventability included asthma/chronic obstructive pulmonary disorder, depression and thromboembolic cerebrovascular event (23.3, 18.5 and 18.3%, respectively, were potentially preventable). Other hospitalizations that were less common but had a high level of preventability (at least 20%) included hip fracture, impaction, renal failure, acute confusion, bipolar disorder and hyperkalaemia.
The results of this study highlight those conditions where hospitalizations could potentially be avoided through improved medication management. Strategies to increase the awareness, identification and resolution of these medication-related problems contributing to these hospitalizations are required in Australia.
通过将临床指标应用于行政索赔数据，确定澳大利亚老年退伍军人中潜在可预防的药物相关住院治疗的患病率。
对 2004 年 1 月 1 日至 2008 年 12 月 31 日期间澳大利亚退伍军人人群进行回顾性队列研究。
在 5 年研究期间，共有 109044 名退伍军人因药物相关临床指标组定义的一次或多次住院而被纳入研究。
潜在可预防的药物相关住院治疗的患病率，占临床指标组定义的所有住院治疗的比例。
在 5 年研究期间，共有 1630080 人次住院，其中 109044 名退伍军人中有 216527 人次（13.3%）因药物相关临床指标组定义的情况住院。潜在可预防的药物相关住院治疗的总体比例为 20.3%（n=43963）。在纳入研究的 109044 名退伍军人中，28044 名（25.7%）至少有一次潜在可预防的药物相关住院治疗，7245 名（6.6%）退伍军人有两次或两次以上潜在可预防的入院。住院率高且可预防的情况包括哮喘/慢性阻塞性肺疾病、抑郁症和血栓栓塞性脑血管事件（分别为 23.3%、18.5%和 18.3%，为潜在可预防）。其他住院率较低但可预防程度较高（至少 20%）的情况包括髋部骨折、嵌顿、肾衰竭、急性意识障碍、双相情感障碍和高钾血症。
本研究结果突出了那些通过改善药物管理可能避免住院的情况。澳大利亚需要提高对导致这些住院治疗的这些药物相关问题的认识、识别和解决策略。
